局部进展期结直肠癌侵及膀胱的扩大根治性手术  

Extent radical surgery for locally advanced colorectal carcinoma invading the bladder

作　　者：陈创奇[1] 黄奕华[1] 汪建平[1] 彭俊生[1] 董文广[1] 詹文华[1] 

机构地区：[1]中山医科大学附属第一医院胃肠胰外科,广州510080

出　　处：《中华胃肠外科杂志》2001年第4期241-244,共4页Chinese Journal of Gastrointestinal Surgery

摘　　要：目的探讨局部进展期结直肠癌(LACRC)侵及膀胱的外科治疗。方法对侵及膀胱的LACRC24例进行回顾性分析。结果原发癌22例,复发癌2例。所有患者均行扩大根治性手术,切除范围包括全膀胱切除8例(TC组)和部分膀胱切除16例(PC组)。住院期间的病死率为0,并发症发生率为33.3%(8/24),其中TC组2例,PC组6例。总的复发率为33.3%(8/24),TC组和PC组的复发率相近,分别为37.5%和31.2%(P>0.05)。本组术后1、3、5年生存率分别为91.1%、58.3%和46.6%,其中TC组术后1、3、5年生存率分别为100%、51.4%和51.4%,而PC组则分别为86.7%、61.5%和43.9%,两组间差异无显著性意义(P>0.05)。结论对侵及膀胱的LACRC应根据具体情况选择合适的手术治疗,根治性手术可望提高患者术后生存率。Objective To investigate surgical therapy for locally advanced colorectal carcinoma (LACRC) invading the bladder. Methods Twenty four patients with LACRC invading the bladder from January 1990 to December 2000 were analyzed retrospectively.Results Twenty two patients had primary tumor and 2 had locally recurrent carcinoma. All the patients underwent extent radical surgery, which included total cystectomy (TC group, n=8) and partial cystectomy (PC group, n=16). The in hospital mortality was 0, and complication morbidity was 33.3% (8/24), which included 25% (n=2) in TC group and 37.5% (n=6) in PC group. The total recurrence rate was 33.3%(8/24), which included 37.5% (n=3) in TC group and 31.2% (n=5) in PC group. The two groups recurrence rates were similar (P >0.05). The postoperative 1 , 3 , 5 year survival rates of all patients were 91.1%, 58.3% and 46.6% respectively. The survival rates were similar in TC and PC group (P >0.05), respectively 100% versus 86.7% at one year, 51.4% versus 61.5% at three years and 51.4% versus 43.9% at five years. Conclusions Rational surgical therapy should be chosen on the base of different conditions with LACRC invading the bladder. Curative surgery can improve the postoperative survival rate.

关 键 词：结直肠肿瘤 膀胱切除术 外科治疗 

分 类 号：R735.3[医药卫生—肿瘤]